Ultrasound-guided bilateral stellate ganglion blockade to treat digital ischemia in a patient with sepsis: a case report

Abstract

This case illustrates the potential advantages of ultrasound-guided stellate ganglion blockade for the treatment of sepsis-related digital ischemia refractory to standard therapy.

Multiple bilateral ultrasound-guided stellate ganglion blocks to treat acute vasculitis in a recently diagnosed patient of systemic lupus erythematosus

“…In one patient, the block was given by ultrasound twice in a ventilated patient for vasculitis secondary to sepsis with the authors justifying the bilateral block as the patient was ventilated negating concern for bilateral blockade of phrenic and recurrent laryngeal nerves. [10] In the other two described patients, ultrasound bilateral block was given only once for refractory ventricular arrhythmias and burning mouth syndrome. [1112]…”

“…[9] However, bilateral stellate ganglion block is rarely given due to the concern of phrenic and recurrent laryngeal nerve palsy. [101112] In this article, we describe the management of a recently diagnosed SLE patient who presented with progressive gangrene of fingers of both upper limbs. Accordingly, meticulously planned serial bilateral guided stellate ganglion blocks were successfully given by ultrasound technique to prevent impending loss of digits with no complications.…”

Sepsis-induced digital ischaemia in a professional pianist, in the absence of vasopressors

“…Vasodilation by local sympathetic blockade has also been strongly advocated, particularly through the use of stellate ganglion anaesthesia (table 3). 3 5 10 17 Therapeutic anticoagulation precluded this technique. Instead, an axillary brachial plexus block was successfully performed on the right arm.…”

Stellate Ganglion Blockade in Digital Ischemia Due to Raynaud’s Phenomenon: A Case Report

“…Stellat ganglion inferior servikal ganglion ve birinci torasik ganglion füzyonundan oluşmaktadır ve üst ektremite, parmakların mikrosirkülasyonunda ana düzenleyici role sahiptir [3,4] . Stellat gangliyon blokajı şimdiye kadar vazomotor semptomlu hastalar, kompleks rejyonal ağrı sendromu, refrakter ventriküler aritmi ve vazopressör ekstravazasyonuna bağlı iskemik parmak kurtarma için kullanılmaktadır [5] .…”